Jung At Heart

I am borrowing both title and idea for this post from Blue to Blue. Thinking about what books more or less related to psychotherapy, I realized that novels have been more influential for me than more traditional sources. Probably because I have always been a little lazy intellectually and lack the depth in philosophy that some have. So in no particular order of importance, here are ten books that have stayed with me and in both subtle and not so subtle ways helped to shape my thinking about what I do.

1. Freud's Introductory Lectures on Psychoanalysis -- the basic text for my second course in psychology in college, taken when I was a sophomore. Whether it was the ideas of Freud or the genius of the professor, Irwin Kremen, this book and course grabbed me and really got my interest in psychotherapy and in the workings of the mind going.

2. Man and His Symbols -- Carl Jung. I discovered this book while browsing in the Gothic Bookshop sometime when I was a junior in college. I was fascinated by the ideas, though I didn't understand a lot of them. 

3. I Never Promised You a Rose Garden -- also read while I was in college. I count myself lucky to have encountered these books n my college years when psychoanalysis and depth psychology was still the dominant mode.  This novel set me to browsing the shelves of the library reading all kinds of books about psychotherapy and psychoanalysis.

4. August -- I still recommend this novel by Judith Rossner to friends. The novel focuses on the relationship between a psychoanalyst, Dr. Lulu Shinefield, and a young troubled woman, Dawn Henley, from the beginning of their therapy together through to its termination. And because it gives us perspective from both sides of the couch, I think it is really unusual.

5. The Words to Say It- Claudia Cardinal. Around 20 years ago, a patient gave me this book. It is a fictionalized report of the author's seven years in psychoanalysis and gives a sense of that process. 

6. The Treatment - Daniel Menaker's novel about Jake Singer and his analysis with Dr. Morales, a wild and passionate analyst. Though Dr. Morales behaves as likely no analyst would, his passion and willingness to engage Jake in the way he does captures the excitement that I find at the heart of this work. 

7. Schizoid Phenomena, Object-Relations, and the Self - Harry Guntrip. Through the 70's and 80's I read widely in psychoanalysis, object relations, Jungian psychology. I would look at the bibliography of any book I liked and find as many of those books that sounded interesting to me and read them. This gave me an intensive education that I couldn't have gotten any other way. This book, with its awkward title, was one I went back to a couple of times. 

8. Psychotic Anxieties and Containment: A Personal Record of an Analysis With Winnicott -  Margaret Little. This little book, just 129 pages, was terrific for giving me a deep sense of what it is to be a wounded healer. Not many analysts or therapists write about their own wounds and madness. Margaret Little gives a tremendous gift in this account of hers.

9. Women Who Run With The Wolves - Clarissa Pinkola Estes. I go back to this book again and again, drawn by different fairytales and her analysis of them. To my mind, this is one of  the best books  based on Jungian principles and most accessible to the general public.

10. Of Two Minds: An Anthroplogist Looks at American Psychiatry - T. M. Luhrman. An interesting look at the split in psychiatry between those who lean to brain and those to mind.

Of course in the process of writing this list, another dozen or so books sprang to mind. I'll save them for another day.

Someone asked me how a psychotherapist deals with the situation in which something the patient has come to understand she would really like to do to improve or change her life is likely to cause suffering to someone in that patient's life?   

This questions contains, I believe, a misperception about what therapy is about and what the role of the therapist is.  

A new patient comes to me. I gather a bit of basic data and then ask her to tell me why she is here, to tell the story in whatever way makes sense for her. I listen. Very rarely is what I hear framed as a moral dilemma. I ask and ask many times during the time we work together "What is the life you want?", because this is a pivotal issue. And as she frame possible actions, I ask if that action will take her closer to the life she wants. And we do that process again and again. I don't tell anyone what to do. I am not really a problem solver.  

I deal with what is the life the person wants, what keeps them from having that life, and how/if it can be achieved and what the cost of achieving it might be. In 36 years I have never seen a pedophile or rapist or person who engages in behavior that I think is beyond the pale -- those people don't come in for therapy, at least not to me. Once I saw a person who might have been a murderer. I checked with colleagues and the appropriate state agency to see what my responsibility was to him and to the community. I saw him 3 times and discharged him to more appropriate facility. That was a professional decision not a moral one.  

So how do psychotherapists navigate these waters?  

I don't give answers when asked what people should do. I can help them look at why they want to do it and what the consequences are and whether it will get them what they want. But I do not make the decision.  

In two sets of conditions, I am bound to act on what I hear. If I am told by someone that they abuse someone or are abused, in most states, I am mandated to report the abuse. If someone threatens the life of another, case law says I must inform the authorities, but statute does not -- so I consult and then report or not. Otherwise, my task is to listen.  

I am not Dr. Phil. I am not a priest. It is VERY hard sometimes not to try to tell people what to do. Because the work I do is not short term and because I usually work with people over the course of months, often  years, we have time to sort through issues, to examine them from as many sides as possible. And ultimately what they do is up to them. 

"The principle aim of psychotherapy is not to transport one to an impossible state of happiness, but to help (the client) acquire steadfastness and patience in the face of suffering. " -C.G. Jung

A while back someone told me that she had changed herself from an introvert into an extravert, by way of explaining her enthusiasm for door to door campaigning. But did she really change her basic self or did she learn to adopt what we Jungian would call an extraverted persona? C. G. Jung applied the words extravert and introvert in a different manner than they are most often used in today’s world. As they are popularly used, the term extraverted is understood to mean sociable or outgoing, while the term introverted is understood to mean shy or withdrawn. Jung, however, originally intended the words to have an entirely different meaning. He used the words to describe the preferred focus of one’s energy on either the outer or the inner world. Extraverts orient their energy to the outer world, while Introverts orient their energy to the inner world. My best guess is that the direction of her energy remains toward her inner world but she has learned how to present herself in an extraverted manner when the occasion demands it.

For example, those who know me only from my teaching or workshop presentations would swear that I am extraverted. I am at ease speaking in front of groups, animated, energetic. But what they do not realize is that is a costume of sorts that I wear for those settings, that I wear because I have a role to play. The "real" Cheryl is the introverted one. So, in order to be effective as a teacher or speaker, I did not change who I am; rather I became adept at donning the costume of a more extraverted version of myself.  In part in order to do that I need to be more accepting of who I am, of my basic nature in order to take on a persona that works for me. 

Therapy for many people, maybe most who seek it is about change -- changing how they feel, changing relationships, changing the direction of their lives.  And many times they don't have a clear idea of what that means, just that they are unhappy as things are. I often ask patients what is the life that they want? What would it look like? How would it be different? And what stands between them and having that life? Then comes the hard work of dealing with those obstacles, often self-created. It is important to deal with the past, to work through those issues and finally come to acceptance that it is what it is. And get on to the business of playing the cards that we have been dealt. Because we can't change the circumstances of our birth, the parents we have, the childhood we lived, the forces that shaped us. We can change how we see those things but they themselves will not change. In fact it is acceptance that paves the way for change.

I have been asked if I could see a difference in my own life from having been in therapy. Someone who knew me when I was 25 and knows me now would not notice too very many things different about me except that I am heavier, my hair is grey and I am wearing glasses rather than contacts -- all external manifestations of age and the life I have lived. Someone who knew me very well then and now might notice that I am calmer, less prone to sarcasm, more contemplative, warmer, more confident. They would recognize my delight in words and willingness to express opinions, that I have a dry sense of humor. That I am a bit shy and reserved, keep a pretty tight zone of privacy around myself. But on the whole, I would likely seem more relaxed.

The changes I have experienced in my life as the result of a long and successful analysis are interior, and though they shape what others see, are most likely unknown to others. Those inner changes were hard won. 

How are the changes sustained? They are sustained by my recognition that I have more and more of the life I want including that I have work I love. And these act powerfully to reward my efforts every day and so that every day that change becomes easier to sustain.